| Doctor Name: | MR. ROGER JASON PLOG |
| NPI Number: | 1336124882 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | VA00016310 |
| Business Practice Address: | 653 156th Ave Ne Bellevue, WA - 980074823 |
| Business Phone Number: | 4256419127 |
| Business Fax Number: | 4256419108 |
| Mailing Address: | 1631 154th Ave Se, BELLEVUE |
| State: | WA |
| Postal Code: | 980076146 |
| Phone Number: | 4257478729 |
| Fax Number: | |
| NPI Enumeration Date: | 12/07/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 183700000X |
| License Number: | VA00016310 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacy Technician |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. |